Integrating a whānau-ora approach in primary care to mitigate the impact of syndemics: whānau and key informant views.

BACKGROUND

Whānau-centredness is core to Māori wellbeing. Western models of health, in contrast, tend to be deficit-framed and individualistic, although a more collective model can be seen in the concept of syndemics: conditions that cluster in populations and are amplified by health inequities. Through the voices of whānau and key informants, we investigated how a whānau-ora approach can inform the management of syndemics of long-term conditions and infectious diseases within primary health care.

METHODS

The study team was gifted the Māori name Pūriri [a medicinal tree] by a community leader, enabling the concept of syndemics to be considered in a Te Ao Māori context. We undertook a qualitative kaupapa Māori study, conducting focus groups and interviews with purposively selected participants. We utilised descriptive and inductive thematic analysis.

RESULTS

We identified several themes to guide appropriate management of syndemic conditions in primary care. Participants stressed the importance of whakawhanaungatanga and strengths-based practices when working with whānau; culturally appropriate services that are grounded in Māori worldviews; whānau engagement in care; and whakawhanaungatanga, which is also vital at the Provider level.

CONCLUSIONS

This paper reports findings from a Māori-led study, building on existing research focused on whānau-centred care and established approaches to Māori health. Building trusting, respectful connections through whakawhanaungatanga was seen as a central practice for engaging with Māori. Grounded in the symbolism of the Pūriri, these findings highlight pathways for primary health care to partner with whānau and communities in a whānau-ora approach to create enduring and equitable solutions to syndemics.